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Organization
HUMANA MEDICAL GROUP INC
Active
Organization
HUMANA MEDICAL GROUP INC
Active
Other names
George Danial D O
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE DANIAL DO (OWNER PRESIDENT)
(818) 981-0050
Entity
Organization
Contact information
Practice address
4621 RUBIO AVENUE, ENCINO, CA 91436
(818) 981-0050
(818) 907-7080
Mailing address
4621 RUBIO AVENUE, ENCINO, CA 91436
(818) 981-0050
(818) 907-7080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A4720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX47200
—
CA
01
—
20A4720
BSBC OF CALIFORNIA
—
05
—
GR0065060
—
CA
01
—
P00065141
UNITED HEALTHCARE
GA
01
—
P00065141
RAILROAD MEDICARE
—
Enumeration date
09/17/2006
Last updated
06/30/2015
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